Term
What evidence based practice includes?
(3 prong approach) |
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Definition
1. using evidence (research)
2. Look at patients values and goals
3. use you personal clinical expertise (even when you know something works but hasn't been proven its still part of evidence based practice, collect data to prove this) |
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Term
| PICO - clinical question formation |
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Definition
-Client or problem being considered
-Intervention/treatment being considered
-Comparison (where its relevant)
-Outcome or outcomes of interest that you would like to measure or achieve. |
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Term
How is clinical reasoning used by OTs?
(note: this is discussed further with each of the 6 types of reasoning) |
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Definition
| -To complete the occupational profile (scientific and narrative reasoning used), to assess occupational performance (use scientific and narrative reasoning), and to assess their environment(use narrative and conditional reasoning). |
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Term
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Definition
-decisions are based on the diagnosis
-How is the child's disability affecting performance?
-Are norm referenced, standardized test tools used? (if blind or def for ex. don't use norm referenced tool)
-use more then one practice model to treat the child.
-Example use behavioral model but due to autism has sensory issues so also use sensory integration, also social problems so use social cognitive model.
-Ex. Child with sever spastic CP, need to learn movement patterns = neuro model
-Use age appropriate activities. |
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Term
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Definition
-Decision based on Childs story (CPR) SES
-Family concerns, resources
-CPR- concerns priorities and resources |
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Term
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Definition
Decisions based on practical issues i.e. service delivery
Ex. Getting cheaper equipment such as at goodwill
Ex. What if parent can’t be at therapy session b/c of work and non English speaking nanny, could video tape session, could give parent a call and let them know what happened, keep a log for child, to give to parent, email, text. Ideally parent would be there.
Ex. Walk into home and parents all though well meaning, they kept all trash everything and no room to play. How do you help? Work outside, in front or back yard, or at park, or somewhere else. |
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Term
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Definition
Decision to determine how I will interact with child
Role model-indirect, maybe don’t tell them what they should be doing.
What is important to child and family? Most of the time walking is most important to parents.
ADLs, and taking care of childs ADLs.
If not important to the parents, it most likely wont happen
Use visual cues, hand gestures, guide them (proprioceptive cues)
How to build relationship? |
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Term
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Definition
decision based on moral dilemma
Prioritize resources
Limit what you can provide for any one therapy (case to case basis)
Ex. Supervisors wants you to take on more kids but you can say no because you want to provide good service to each child.
Ex. Poor treatment by team member of a child- time out of child only 2, OT said something to lead (teacher).
Ex. Supervising who? COTA, rehab aides, teaching assistants. Would if they do something they are not qualified to do and have done it for 10 years? WE ARE RESPONSIBLE
Don’t want to say they are doing it wrong, instead walk through it together |
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Term
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Definition
decisions based on long term outcome and holistic picture of child
Taking in the whole picture- where should they be down the road. What is more important for the child,
Ex. Improve skills vs. adapt environment
Ex. Conserve energy
Look at long term goal |
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Term
| What are the factors the therapist must consider during intervention planning? |
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Definition
-family priorities and childs
-what skills does the child need to meet occupational roles?
-what developmental trajectory does this child demonstrate?
-influences of performance contexts?
-which theoretical models of practice or frames of reference guide the intervention?
-what is the nature of the disability? |
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Term
| 4 major intervention purposes and strategies? (table 1-2) |
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Definition
1. improving function-occupation as means, "just right" challenge, preparation, individualized, therapeutic use of self, educating caregivers/teachers.
2. adapting activities or providing assistive tech.
3. environment modifications
4. promoting participation and preventing disability through education |
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Term
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Definition
| -occupation as means, "just right" challenge, preparation, individualized, therapeutic use of self, educating caregivers/teachers. |
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Term
| 2. adapting activities or providing assistive technology |
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Definition
compensatory strategies,
concurrent developmental and functional goals,
educating adults who support the use of compensatory strategies, |
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Term
| 3. environment modifications |
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Definition
| improving the fit between child and environment, consultation and negotiation with adults in the child's environment. |
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Term
| 4. promoting participation and preventing disability through education |
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Definition
| educating other professionals and administrators, system change in the child's community. |
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Term
| why are families important in the establishment of occupational therapy intervention? |
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Definition
| -Because their families are the ones that are going to follow through with any in home interventions. Child is under the care of their family and we must establish a good therapeutic relationship with them in order for them to trust our expertise! |
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Term
| OT goals for promoting inclusion (table 1-3) |
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Definition
-decrease students disruptive behaviors
-increase student's time management
-decrease student's aggressive behaviors
-improve students interpersonal skills
-improve students responsiveness and self-regulation
-improve student's attention span and decrease distractibility
-improve students ability to organize and manage materials |
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Term
| Improtance of culture values and styles that influence children's development of occupation (table 1-4) |
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Definition
-family composition (who?, how many?, hierarchy?)
-decision making (who makes the decisions?)
-primary caregiver (who?, is role shared?)
-independence/interdependence (value independence or is reliance on each other more important?)
-feeding practices (who feeds child?, cultural rules/norms about breast feeding-mealtime-self feeding-eating-certain foods?)
-sleeping patterns (where does child sleep?, Do parents respond to infant at night?, what are appropriate responses to crying?)
-discipline (is it tolerated?, strictness of rules?, who disciplines?)
-perception of disability (do parents believe it can improve?, do they feel responsible or that they can make a difference?, spiritual healing value?)
-help seeking (Who do they seek help from?, do they actively seek it or wait for it to come?)
-communication and interaction (direct or indirect style?, do they share emotions?, value of socializing?) |
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Term
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Definition
| -OTs emphasize integrating research findings into their practice and using research evidence in clinical reasoning, this has become essential to clinical decision making. |
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Term
| steps in evidence based practice |
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Definition
1. convert the need for info into an answerable question
2. search the research and track down evidence
3. critically appraise the evidence for is validity and impact
4. critically appraise the evidence for its applicability priorities.
5. implement the practice or apply the info and evaluate the process. |
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Term
| resources in child-based practice |
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Definition
Journal articles, AOTA, NOTA
practice models with research evidence in the literature are NDT, SIT, sensory modalities, collaborative consultation, occupation as an intervention means, family centered care. |
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Term
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Definition
| When the team members work independently c client, not much team interaction or communication, mutal respect, limited communication |
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Term
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Definition
Ongoing communication b/n team members
Regular team meatings where all members get together to discuss problems of client
Ex. Not entire team but part of team, just a couple
Ex. Functional mobility, OT and PT working together |
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Term
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Definition
Ultimate outcome is OT performance of child, defined by IEP (federally mandated doc. And defines special ed for that child and list whose on the school based interdisciplinary team and there roles and when they will see child. Directly= actually go in and work with child. Consult = tell teacher for ex. How to work with child.
Many children in school district have both.
Teacher is leader of the team and lead by educational goals |
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Term
| early intervention transdisciplinary? |
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Definition
Role release- we are the expert on this team and we need to comfortable going in there to give OT intervention, we have to know all about this early intervention. We want to support family. Better for family to just deal with one or two specialist skilled therapists.
Role release- you release OT role to someone else and we take on the intervention of other disciplines |
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Term
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Definition
-Inclusion and Services in Natural Environment
-Cross-cultural competence (the ability to think, feel, and act in ways that acknowledge, respect, and build upon ethnic, sociocultural, and linguistic diversity)
-Assistive Technologies and universal access
-Evidence-based practice
-Ideals in our professions (what we strive for)
Natural environment (where people learn best, it’s their world-Blind or def kids learn better in contained environments though)
-Universal access (being sure child with disabilities able to access everything as typical child would) |
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Term
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Definition
-Engagement in daily activities that reflect cultural values, provide structure to living, and meaning to individuals; these activities meet human needs for self-care, enjoyment, and participation in society.
-main occupation of children is play, and OT understand it is essential for development and they study the concepts and assumptions that underlie the theories of play. |
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Term
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Definition
| individualized education plan (federally mandated document that defines the special education of that particular child, defines who is on the interdisciplinary team and what their roles are, how often they see the child |
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Term
| contexts for the development of childhood occupation |
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Definition
-cultural
-personal
-social
-physical |
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Term
| Model of practice/FOR determine what 3 things? |
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Definition
1. who will receive therapy
2. what intervention strategies will be used
3. when and where therapy will be provided |
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Term
| Erickson (stages of personality development) |
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Definition
1 Trust vs. Mistrust
• 2 Autonomy vs. Shame/doubt
• 3 Initiative vs. Guilt
• 4 Industry vs. Inferiority
• 5 Identity vs. Role Confusion
• 6 Intimacy vs. Isolation
• 7 Generativity vs. Stagnation
• 8 Ego Integrity vs. Despair |
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Term
Erickson
stage 1
Trust vs. Mistrust |
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Definition
-birth to 1
-purpose=infant learns that needs will be met; paents will return after absence; contingencies.
-adverse Rx=fearful toward others
-virtue=HOPE |
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Term
| What goals drive School based interdisciplinary teams? |
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Definition
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Term
Erickson
stage 2
Autonomy vs. Shame/doubt |
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Definition
-1-2yrs.
-purpose=differentiation of "self" wishes from others; learns control over basic physiologic funcs. and social exchange (saying NO!)
-Adverse Rx=insecurity, dependency, clingy, tearful
-Virtue=WILL |
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Term
Erickson
stage 3
Initiative vs. Guilt |
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Definition
-Preschool 3-5yrs
-Purpose=begins to make or construct things in play; accepts parents as role models; "busy"
-Adverse Rx=belief that thoughts and actions are wrong, inferior, or bad.
-Virtue=PURPOSE |
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Term
Erickson
stage 4
industry vs. Inferiority |
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Definition
-Childhood 6-12yrs
-purpose=entering school; child is very proud of accomplishments.
-Adverse Rx=consistent failure may lead to a sense of inferiority
-Virtue=COMPETENCE |
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Term
Erickson
stage 5
identity vs. role confusion/identity diffusion |
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Definition
-adolescence
-purpose=importance of peer relationships; separation from parents; tries out new roles; integration of previous resolution.
-Adverse Rx=inability to identify roles, establish a self-identity and awareness.
-Virtue=FIDELITY (quality of being faithful) |
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Term
Erickson
stage 6
intimacy vs. isolation |
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Definition
-young adult
-purpose=uses identity established in previous stages; forms intimate relationships with friends, family, spouse.
-Adverse Rx=inability to form meaningful relationships; fear of commitment
-Virtue=LOVE |
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Term
Erickson
stage 7
Generativity vs. stagnation |
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Definition
-adult
-purpose=becomes part of larger picture; wants to leave lasting mark on society through family and/or work
-Adverse Rx=believe that life is meaningless; extreme self-absorption
-Virtue=CARING |
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Term
Erickson
stage 8
Ego integrity vs. Despair |
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Definition
-older adult
-Purpose=belief that life was worth living; made a lasting contribution; life is what it was-minimal regrets.
-Adverse Rx=regret for what one has done or not done.
-Virtue=WISDOM |
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Term
Piaget
sensorimotor stage |
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Definition
-birth to 2yrs
-Infants by acting on world c eyes, ears, & hands. Result=invent ways of solving problems, such as pulling a lever to hear the sound of a music box, finding hidden toys, and putting objects in and taking them out of containers. |
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Term
Piaget
Preoperational stage |
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Definition
-2-7yrs
-preschool children use symbols to represent earlier sensorimotor discoveries. Development of language and make-believe play takes place. Thinking lacks logical quality. (ex. dress up, playing house, acting) |
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Term
Piaget
Concrete operational stage |
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Definition
-7-11 yrs.
-reasoning becomes logical. School-age children understand that a certain amt of lemonade or play dogh remains the same even after its appearance changes. They also organize objects into hierarchies of classes and subclasses. thinking falls short of adult intelligence. Not yet abstract. |
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Term
Piaget
Formal operational stage |
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Definition
-11 yrs on
-capacity for abstraction permits adolescents to reason with symbols that do not refer to objects in the real world, as in advanced mathematics. They can also think of all possible outcomes in a scientific problem, not just the most obvious ones. |
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Term
| Maslow's hierarchy of needs (from bottom up) |
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Definition
•Physiologic/Health Needs (basic needs- food, health, heat)
•Emotional/Personal Needs (Love, belonging)
•Participation and Extrapersonal Needs (Relationships and group affiliation/occupations emerge)
•Life Satisfaction and Esteem (How we can develop self to be well thought of by others, developing competences, mastery/occupations emerge)
•Self Actualization (Be all that one can be, achieve personal goals)
•***We will all encounter parents that don’t want to focus on occupation so we may first work with family on getting basic needs before we even try to do occupational profile. |
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Term
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Definition
-theorists are Pavlov, Watson, and Skinner
-belief that environment shapes all human behaviors and that they may be randomly emitted in response to an environmental stimulus.
-positive vs. negative reinforcement.
-behavior is strengthened and maintained as long as it is generally effective in obtaining positive reinforcement. |
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Term
| Social Cognitive Theories |
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Definition
-Bandura-children learn by observing the behavior of others.
-child's thoughts and beliefs also influence his/her learning ability and are important to OTs
-acquisition (child observing and determining consequences)
-Performance (childs decision to perform behavior) |
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Term
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Definition
-Vygotsky and zone of proximal development (ZPD)
-believed that cognitive development occurs through the gradual internalization of concepts and relationships encountered through social interactions.
-ZPD reflects the learning potential of the child at a moment in time. Range of task that child cannot handle alone but can accomplish with more skilled partners (parents teachers therapists) |
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Term
Zone of Proximal development
skill development stages |
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Definition
1. assistance provided by others
2. assistance provided by self
3. internalization and automatic habit formation
4. recursiveness (applied repeatably)
5. skill acquired |
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Term
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Definition
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Term
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Definition
-George Miller
-focus on the system by which children extract information from the environment, interpret the information, and organize a behavioral response.
-has source of the sensory input, the method of accessing memories and solving problems (throughput), output (solution/result), and feedback loop to explain the acquisition of knowledge and the use of the results of actions. |
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Term
| Accessing memory - Things that help |
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Definition
-chunking material - categories (5 +/- 2)
-interesting factor/feature
-known pattern |
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Term
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Definition
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Term
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Definition
-Behavior and Learning occurs within the context of subsystems such as the nervous system, body, and environment.
-Influenced the development of occupation based frames of reference: MOHO, PEO, PEOP
-Therapist looks for periods of stability in learning and watches for signs that a child is ready to shift to a qualitatively different type of behavior. |
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Term
| Why is it important for OTs to have knowledge of developmental and learning theories? |
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Definition
| -Theories shape our model of practice! (Models of practice emerge from theory) |
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Term
| Cognitive model of practice (MP) |
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Definition
-focus of helping child develop cognitive strategies, help the child develop own strategies for a task
1. define task
2. examine how currently performing it
3. define where are they having problems
4. with child think about possible solutions
5. try out solutions
6. hope to generalize to other situations |
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Term
| Compensatory/environmental MP |
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Definition
| -Changing the task so it is easier to do by giving them tool/equipment to help or grading activity. |
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Term
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Definition
-Helps child with the external environment
-Builds self-efficacy- hard time socializing
-Change environment- make it an activity where they have to share
-Have them seat next to someone who is helpful
-Teach them coping strategies
-Talk to the child about talking to mean kid
-Can walk away
-Ignore
-If it gets really bad tell teacher
-Communication if still value friendship
-“I” statement
-Role playing options |
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Term
| Social skills development |
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Definition
-Teaching child with poor social skills specific social skills
-Sharing, taking turns, responding to request,
-Kids with autism, aspergers, conduct disorder
-Can teach in group or 1 on 1 |
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Term
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Definition
-Analyze motor patterns
-Analyze best way to provide feedback
-Knowledge of performance and results
-Give many many opts
-Evaluate if they acquire motor skill
-Can they generalize it |
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Term
| Sensory Integration (Ayres) |
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Definition
-Sensory integration dysfunction
-Inability to integrate sensory info to form an adaptive response
-Tx-child participate in specific sensory inputs (V,T, P) to increase adaptive responses
-“classical tx” is in clinic
-Clinic- physically this is where you can have visual, tactile, vestibular response and equipment, can generalize response to environment |
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Term
| Sensory processing (Miller) |
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Definition
-Sensory processing disorder
-Problem with registration, modulation, integration and organization of sensory input
-Tx-help child modulate sensation through sensory diet and env modification
-Practice in clinic or natural environment
-Big push to add to DSM- IV
-Relabeled b/c there is opposition to use sensory integration
-her work grew out of Ayres |
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Term
| Neuro developmental treatment (NDT) |
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Definition
-Carl and Birtha Berbath
-Developed in 1940’s in england
-Dedicated to working with kids who have CP
-Proper positioning and by handling children will develop better functional movement paterns
-Had understanding of brain plasticity
-Considers not just functional performance but the performance skills (production and planning)
-Neuromuscular (ROM, strength, power)
-Looking at Motor skills, patterns |
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Term
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Definition
-Larenzee
-Used work of Piaget, Erikson and Maslow
-Our goal is to help people proceed with life task
-Defined occupation performance of life task
-When do you use this FOR?-Anytime we think about using norms (typically) |
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Term
| What concepts are equated to neuromaturation? |
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Definition
-Movement progresses from primitive reflex patterns to voluntary, controlled movement
-Sequence and rate of motor development are consistent among infants and children
-Low level skills are pre-requisites for certain high level skills |
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Term
Play occupations
birth-6 months |
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Definition
-sensorimotor play predominates
-focused on attachment and bonding |
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Term
play occupations
6-12 months |
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Definition
-sensorimotor play evolves into functional play
-begins to use toys according to their functional purpose
-attachment, relating to parents or caregivers. |
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Term
play occupations
12-18 months |
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Definition
-engages in simple pretend play directed toward self (pretend eating, sleeping)
-explores all spaces in the room
-rolls and crawls in play close to the ground
-begins peer interactions
-parallel play |
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Term
play occupations
18-24 months |
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Definition
-multischeme combinations
-performs multiple related actions together
-makes inanimate objects perform actions
-pretend objects are real/symbolize another object
-participates in parallel play
-imitation of parents and peers in play
-participates in groups of children
-watch other children
-begin to take turns |
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Term
Play occupations
24-36 months |
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Definition
-links multiple scheme combinations into meaningful sequences of pretend play
-uses objects for multiple pretend ideas
-uses toys to represent animals/people
-plays out drama with stuffed animals or imaginary friends
-participates in drawing and puzzles
-imitates adults using toys
-likes jumping, rough and tumble play
-makes messes
-associative, parallel play predominates |
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Term
play occupations
3-4 years |
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Definition
-creates script for play where pretend objects have actions that reflect roles in real or imaginary life
-create art project with adult assistance
-works puzzles and blocks
-enjoys physical play, swinging, sliding, jumping, running
-participates in circle time, games, drawing and art time at preschool
-engages in singing and dancing in groups
-associative play: with other children, sharing and talking about play goal |
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Term
play occupations
4-5 years |
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Definition
-begins games with simple rules
-engages in organized play with prescribed roles
-kick ball, duck duck goose
-takes pride in products
-shows interest in the foal of the art activity
-constructs complex structures
-participates in role play with other children and in dress up
-tells stories
-continues with pretend play that involves scripts with imaginary characters |
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Term
play occupations
5-6 years |
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Definition
-board games, computer games with rules, competitive and cooperative games
-elaborate imaginary play
-role plays stories and themes related to seasons or occupations
-emphasis on reality
-reconstructs real world in play
-participates in ball play
-participates in group activities, organized play in groups
-goal of play (winning) may compete with social interactions at times |
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Term
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Definition
-computer games, card games that require problems solving and abstract thinking
-has collections
-may have hobbies
-cooperative and competitive play in groups/teams of children
-winning and skills are emphasized
-talking and joking
-peer play predominates at school and home |
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Term
| a typically developing child first releases a toy into a container by? |
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Definition
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Term
| a child starts to participate in ball sports at? |
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Definition
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Term
| when does play include talking and joking? |
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Definition
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Term
| when does an infant first uses a lateral pinch to pick up a cheerio? |
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Definition
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Term
| a child lifts his head and raises his trunk in prone by? |
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Definition
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Term
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Definition
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Term
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Definition
| prematurity, CVA, Placental abruption, maternal exposure to environmental toxins, near drowning, maternal infection, CNS infections. |
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Term
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Definition
infection/disease that is contracted by thhe mother through ingestion of raw meat or contact with the feces of newly infected cats and can be transmitted to the fetus at any point during pregnancy.
-effects on fetus= deafness, blindness, MR, seizures, pneumonia, enlarged liver and spleen. |
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Term
| Most common maternal infections...(STORCH) |
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Definition
syphilis
toxoplasmosis,
rubella
cytomegalovirus, and herpes
-STORCH can be secondary causes of CP |
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Term
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Definition
-can be transmitted in the late stages of pregnancy or during delivery.
-effects of fetus= enlarged liver and spleen, jaundice, anemia, rash, rhinorrhea |
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Term
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Definition
-viral infection
-can be devastating when contracted by a pregnant woman especially in 1st trimester.
-congenital defects, spontaneous abortion, and still birth can occur.
-effects on fetus= meningitis, hearing loss, cataracts, cardiac problem, MR, retinal defects. |
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Term
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Definition
herpes-type viral infection may be transmitted before, during, or after birth. may be active or latent in newborn
-LBW, sensorineural hearing loss, microcephaly, hepatomegaly, splenomegaly and purpuric rash. |
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Term
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Definition
-contracted by newborn during or after delivery by a mother with herpes simplex infection, often genital herpes.
-effects on fetus, lethargy, rash, repiratory distress, jaundice, enlarged liver and spleen, generalized form: virus attacks CNS, causing MR, seizures, and other problems. |
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Term
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Definition
| result of injury or disease at or before birth. |
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Term
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Definition
| children injured in early childhood display similar symptoms |
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Term
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Definition
| cognitive, sensory, and psychosocial deficits often compound motor impairments and subsequent functioning. |
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Term
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Definition
| involvement of the upper and lower extremities on one side |
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Term
| tetraplegia/quadriplegia? |
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Definition
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Term
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Definition
| when the child demonstrates quadriplegia with mild UE involvement and significant impairment of function in LEs |
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Term
| what happens over time with CP? |
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Definition
| Although CP is considered nonprogressive, abnormal movement patterns, muscle tone, and sensory function, combined with the effects of gravity and normal growth, may cause the child to develop fxontractures and deformities over time. function may become more limited as the child grows to adulthood. |
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Term
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Definition
-high tone
-not walking
-quadriplegia, but may also manifest as diplegia or paraplegia
-limited midrange control
-no righting/equilibrium reactions
-seizures, blind, deaf, MR, malnutrition, prone to URTI are some problems |
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Term
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Definition
-near normal tone at rest but increases with excitement
-may be able to walk
-equilibrium reactions but not in standing
-ear better and speak better with some difficulty |
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Term
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Definition
-often able to walk
-diplegia and hemiplegia are more common
-more distal limitations with minimal deformities
-can eat normal diet
-poor lip closure casing drooling |
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Term
| athetosis with spasticity |
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Definition
-decreased ability to grade movements
-Choreathetosis- involuntary/purposeless movements
-decrease coordination of suck-swallow resulting in decreased feeding and speech |
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Term
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Definition
-unusual for CP
-ungraded, slow movements
-hanging onto anatomic structures
-poor equilibrium reaction
-obesity due to lack of mobility
-sensory impairment, URTI
-decreased motivation - good baby because can't move |
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Term
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Definition
- lacks point of stability and co-activation is difficult
-incoordination thus dysmetria (impaired ability to estimate distance in muscular action), disdiadochokinesia (impairment of the ability to make movements exhibiting a rapid change of motion), tremors at rest, symetric problems.
-very slow monotone speech with decreased articulation
-Nystagmus, MR, sensory problems, does not like to move. |
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Term
| Most common causes of brain injuries |
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Definition
| -falls, motor vehicle accidents, assult or abuse and sports and recreation injuries. |
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Term
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Definition
| -result from the head striking a surface or a moving object striking the head. |
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Term
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Definition
| -typically the result of rapid acceleration and deceleration of theh brain inside the skull, resulting in a shearing or tearing of brain tissue and nerve fibers. |
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Term
| assessment tool used to determine the severity of brain injury? |
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Definition
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Term
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Definition
Eye opening (4 [spontaneous] to 1[no response])
Motor response (6 [obeys] to 1 [no response])
Verbal response (5 [oriented] to 1 [no response]) |
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Term
GCS ranges from 3-15
severe moderate minor??? |
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Definition
8 or lower is severe TBI
9 to 12 is moderate TBI
13 or higher is minor TBI |
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Term
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Definition
-can be distinguished from autism by the fact that these children do not exhibit clinically significant delays in language skills.
-severe and sustained impairments in social interaction and the developments of restricted, repetitive patterns of behavior, interests, and activities.
-lack of nonverbal communication and empathy
-more prevalent in boys |
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Term
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Definition
-severe and complex impairments in reciprocal social interaction and communication skills and by the presence of stereotyped behavior, interests, and activities.
-lack of eye contact, facial expression, peer interaction, social reciprocity, joy, delay in social anticipation.
-nonverbal, limited language, echolalia, syntax problems, mixed up pronoun reversal
-repetitive behaviors, sensory and perceptual processing problems (hyper-reactive or under-reactive) |
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